DR. MICHAEL G. PERSICO (NPI# 1275574550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275574550 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL G. PERSICO |
| Credential | MD |
| Practice Address |
260 W Sunrise Hwy Suite 200 Valley Stream NY 11581-1011 |
| Mailing Address |
441 9th Avenue Acpny Credentialing Office - 3rd Floor New York NY 10001 |
| Practice Telephone | 5168253600 |
| Practice Fax Number | 5168232051 |
| Mailing Telephone | 6466802894 |
| Mailing Fax Number | 5165425556 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 140320 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00905913 | 05 | |
| NY | MEDICARE ID | 46D393K511 | 01 |
| Street Address |
260 W SUNRISE HWY SUITE 200 |
| City | VALLEY STREAM |
| State | NY |
| Zip Code | 11581-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023017464 | Mark R Kahn | Dermatology | 260 W Sunrise Hwy, Suite 305, Valley Stream, NY 11581-1011 | 2005-07-19 |
| 1013432905 | Abimbola Jaiyesimi | Nurse Practitioner | 260 W Sunrise Hwy, Ste. 200, Valley Stream, NY 11581-1011 | 2017-08-11 |
| 1417472143 | Sunrise Podiatry PC | Podiatrist | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2017-08-03 |
| 1013309400 | Queens Long Island Dental Care PC | Dentist | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2015-02-23 |
| 1356739668 | Valley Stream Professional Medical Services, LLC | Radiology | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2015-01-08 |
| 1922396787 | Madiha Majid | Internal Medicine | 260 W Sunrise Hwy, Ste 200, Valley Stream, NY 11581-1011 | 2011-07-14 |
| 1114216249 | Jewel Liao | Ophthalmology | 260 W Sunrise Hwy, Ste 200, Valley Stream, NY 11581-1011 | 2011-03-29 |
| 1962718916 | Rose-therese Raphael | Nurse Practitioner | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2010-08-27 |
| 1922330679 | Sharon K Harper | Pharmacist | 260 W Sunrise Hwy, Pharmacy, Valley Stream, NY 11581-1011 | 2010-02-05 |
| 1811228703 | Nicolas M Aquino II | Internal Medicine | 260 W Sunrise Hwy, Valley Stream, NY 11581-1011 | 2010-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773437 | Step 2 Smile Physical Therapy PC | Physical Therapist | 74 Sylvan Place, Valley Stream, NY 11581 | 2019-05-01 |
| 1700369220 | Lyubov Nikolayeva | Nurse Practitioner | 76 Halyard Rd, Valley Stream, NY 11581 | 2018-09-11 |
| 1154846871 | Shayena Donaldson-fortune | Occupational Therapist | 100 Lotus Oval N, Valley Stream, NY 11581 | 2017-08-03 |
| 1255877080 | Fulin Wang | Acupuncturist | 45 Dartmouth St, Valley Stream, NY 11581 | 2017-01-18 |
| 1356796072 | Idit Ariel Zim | Speech-Language Pathologist | 924 Crestview Ave, Valley Stream, NY 11581 | 2016-05-02 |
| 1487086245 | Florence Jean Baptiste | Behavioral Analyst | 790 University Street, North Woodmere, NY 11581 | 2013-08-05 |
| 1760824254 | Tatiana Grant | Counselor | 70 Sunrise Hwy, Suite 500 #579, Valley Stream, NY 11581 | 2013-07-24 |
| 1740625698 | Patricia R. Curtis | Specialist | 96 Roosevelt Ave., Valley Stream, NY 11581 | 2013-05-06 |
| 1669769006 | Fredrica Beth Lieberstein | Health Educator | 792 Longview Avenue, North Woodmere, NY 11581 | 2011-07-06 |
| 1811288186 | Bruce Neil Goldman | Speech-Language Pathologist | 1030 Cedarhurst Street, North Woodmere, NY 11581 | 2011-04-21 |
| Find all providers in zip 11581 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720209521 | Noel Edwin Blackman | Surgery | 83 Law St, Valley Stream, NY 11580 | 2007-05-01 |
| 1982646410 | Fred Nicolas | Surgery | 766 Daniel St, Valley Stream, NY 11581-3502 | 2006-06-11 |
| 1174564264 | Ira Klonsky | Surgery | 210 E Sunrise Hwy, Suite 303, Valley Stream, NY 11581-1329 | 2006-06-09 |
| 1205442100 | Madeleine Ann Reyes | Surgery | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-09-17 |
| 1104200641 | South Nassau Physicians PC | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2015-07-15 |
| 1245575448 | Li Premier Medical Care Pllc | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2012-11-29 |
| 1962652685 | South Nassau Physician Practice PC | Surgery | 1 S Central Ave, Valley Stream, NY 11580-5443 | 2008-09-30 |
| 1972656437 | Island Surgical Practice PC | Surgery | 210 E Sunrise Hwy, Suite 303, Valley Stream, NY 11581-1329 | 2007-01-19 |
| 1679635833 | Rafael C Hernandez | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2006-12-14 |
| 1588726715 | Victor Hugo Taranto | Surgery | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2006-12-14 |
| Find all providers in VALLEY STREAM | ||||
| City | VALLEY STREAM |
| Zip Code | 11581 |
Please comment or provide details below to improve the information on DR. MICHAEL G. PERSICO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.